Authors:

Divison of Plastic and Reconstructive Surgery, University of the Study of Naples "Federico II".

Background: In the multidisciplinary treatment of obesity, the role of a plastic surgeon is to remove the excess of skin after weight loss to obtain cosmetic, functional, and psychological benefits. Obesity modifies body geometry, increases the mass of different segments, and imposes functional limitations in life activities that may predispose the obese to injury. The authors evaluated the postural conditions of obese patients, before and 12 months after surgery. Read More

Authors:

Postmastectomy reconstruction in patients with significant macromastia and/or large chest wall dimensions can be challenging. Implants have a limited size range and may not be large enough to adequately reconstruct a wide, obese patient. Abdominally based flaps may be unsafe in these patients if they have significant obesity and or other comorbidities and may still be insufficient to adequately fill a very large breast footprint. Read More

Authors:

Plastic and Reconstructive Surgery, University of Ljubljana, Ljubljana, Slovenia, EU.

Background: Breast numbness is a recognized problem following mastectomy and subsequent reconstruction. Contemporary literature acknowledges the positive role of breast neurotization, but it is characterized by a variety of technical approaches and substantial heterogeneity with respect to the degree of recovered sensibility that remains suboptimal in comparison with other sensory nerve reconstructions. This study's purpose was to provide an anatomical basis for observed inconsistencies and therein provide a principle that can be used to develop a technical approach that will optimize sensory recovery. Read More

The different types of sutures utilized in plications and for correction of diastasis during abdominoplasty are reviewed and discussed. Because correction of abdominal deformities also involves fascia and muscle advancement, this review also covers the suture materials used in muscle advancement. The selection of specific techniques to treat different types of abdominal wall deformity is also considered. Read More

Authors:

Treatment of ventral hernias with "loss of domain" is a surgical challenge, and in this review, an overview of the current literature is presented. Abdominal compliance can be increased intra-operatively by performing component separation and/or organ reduction but leads to increased post-operative morbidity. As a result, preoperative methods, which increase abdominal compliance, are of interest: tissue expanders, progressive pneumoperitoneum, and botulinum toxin A. Read More

Introduction: As the number of bariatric surgeries has increased, so has the demand for post-bariatric abdominoplasty. The aim of this study was to describe a new approach to anchor-line abdominoplasty for the treatment of post-bariatric surgery patients.

Methods: This prospective, longitudinal, single-center study was conducted with 20 women, 23-47 years of age, with a body mass index Read More

Background: Due to the technical difficulty, it is not common to close the pelvic peritoneum in laparoscopic abdominoperineal resection (LAPR) in China, which increases the risk of related complications. Permanent sigmoid colostomy is performed through the transperitoneal route conventionally in LAPR. This leads to the high occurrence of parastomal hernias and bowel obstructions. Read More

Authors:

Department of Anatomic Pathology, Kangwon National University School of Medicine, Chuncheon, Korea.

After gastrojejunostomy, a small space can occur between the jejunum at the anastomosis site, the transverse mesocolon, and retroperitoneum, which may cause an intestinal hernia. This report presents a rare case of intestinal ischemic necrosis caused by retroanastomotic hernia after subtotal gastrectomy. A 56-year-old male was admitted to Kangwon National University Hospital with melena, abdominal pain, and nausea. Read More

Authors:

In 1993 Leblanc published his laparoscopic technique in ventral hernia repair. The procedure has been improved due to deeply change of the paradigm in abdominal wall reconstruction. Placing the mesh into the retrorectus space was initially a big challenge but now the Rives-Stoppa procedure by endoscopic approach extended total extra-peritoneal approach (eTEP) become a well known technique. Read More

Bladder exstrophy is a congenital and rare malformation of the lower abdominal wall with exposure of the bladder mucosa to the external environment, and it is related to pelvis abnormalities. Eighteen patients with bladder exstrophy were treated with bilateral oblique pelvic osteotomy in conjunction with urologic reconstruction after they were stabilized by cast. No failure of midline closure was observed (wound dehiscence or recurrence of bladder exstrophy). Read More

Background: The umbilicus is an indicative aesthetic component of the abdomen. Many umbilicoplasty techniques have been defined and the most commonly used method is the round incision technique. In this paper, we present a new umbilicoplasty technique involving the use of a three-armed star flap and compare it with the round technique. Read More

Authors:

Madison, Wis. From the Division of Plastic and Reconstructive Surgery, University of Wisconsin.

Background: Opioid overprescribing is a nationwide problem contributing to the current epidemic. This study evaluated opioid consumption, physician prescribing, and patient satisfaction with pain control following outpatient plastic surgery procedures.

Methods: Patients completed a questionnaire during their first postoperative visit. Read More

Authors:

Learning Objectives: After studying this article and viewing the videos, the participant should be able to: 1. Describe the safe techniques recommended for patients undergoing a lipoabdominoplasty. 2. Read More

Background: Asymmetry of the hips and its implication in body contouring procedures has not yet been reported. Hip asymmetry is common in the general population and may account for uneven abdominoplasty scar and the apparent discrepancies in volume following liposuction of the hips and flanks. The goal of this study was to determine the presence of hip asymmetry in women presenting for abdominal contouring surgery. Read More

Authors:

Background: The umbilical float mini-abdominoplasty has been criticized for low final umbilicus position and umbilical distortion. The authors believe that in the properly selected patient and with proper technique, the umbilical float can achieve superior aesthetic results in a subset of patients.

Methods: A retrospective review was performed of all umbilical floats performed by two surgeons (B. Read More

Background: The proliferation and adipogenic differentiation of adipose stromal cells (ASCs) are complex processes comprising major phenotypical alterations driven by up- and downregulation of hundreds of genes. Quantitative RT-PCR can be employed to measure relative changes in the expression of a gene of interest. This approach requires constitutively expressed reference genes for normalization to counteract inter-sample variations due to differences in RNA quality and quantity. Read More

Authors:

Department of Neurosurgery, Kobe University Graduate School of Medicine.

Secure reconstruction in transsphenoidal surgery (TSS) is important for the prevention of the major and serious complication of postoperative cerebrospinal fluid (CSF) leak. Although abdominal fat can be safely and effectively used as a reconstruction tissue, harvesting it from the abdominal wall is traumatic and invasive, resulting in cosmetic problems. In this report, we present a method of harvesting abdominal fat using a minimally invasive liposuction technique to avoid cosmetic issues. Read More

Introduction: The navel plays a major role in the aesthetics of the abdomen. A navel that is abnormally shaped, malpositioned or has evident scarring may compromise the outcome of an otherwise well-executed full abdominoplasty. The aim of the technique in question is to recreate a navel that looks natural, with no visible scar, and that is properly positioned. Read More

Authors:

Introduction: Ventral hernias are a common problem after exploratory laparotomy, and plastic surgeons often become involved for hernia repair in complex situations. Plastic surgeons can achieve fascial closure through primary repair, an external oblique aponeurosis release, or a transversus abdominis release. Currently, there is scant literature evaluating venous thromboembolism (VTE) rates after these procedures. Read More

Authors:

Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania.

Purpose: Incisional hernia is the most common complication of laparotomy. Postoperative parietal defects tend to relapse, even after the most optimal surgical methods. The aim of this study was to present the effectiveness of an adapted retromuscular technique with prolene mesh and a hernial sac, in patients with large incisional median hernias. Read More

Authors:

Department of General and Transplant Surgery, Medical University of Lodz, Kopcinskiego 22, 90-153, Lodz, Poland.

Purpose: Estimation and comparison of results after incisional hernia repair (IHR) modo onlay or sublay with abdominoplasty in patients who lost the weight following Roux-en-Y Gastric Bypass (RYGB). Analysis and comparison of changes in quality of life (QL) of these patients prior to RYGB, before and after simultaneous IHR and abdominoplasty.

Introduction: Patients who require highly complex abdominal wall hernia repair with composite soft tissue free flap coverage represent the most challenging population, and the most difficult to definitively treat. For many, this combined procedure represents their last chance to restore any sense of normalcy to their lives. To date, patient reported post-operative outcomes have been limited in the literature, in particular, quality of life has been an under-reported component of successful management. Read More

Authors:

Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

Posterior component separation with transversus abdominis release and implantation of synthetic mesh in the retromuscular space is a durable type of repair for many large incisional hernias with recurrence rates consistently less than 10%. The purported advantage of biologic prostheses in contaminated fields has recently been challenged, and the concern for placing synthetic mesh in contaminated fields may be overstated. There are almost no data specifically addressing the use of this type of repair for chronic incisional hernias in trauma and emergency general surgery patients, so research is needed on this patient population. Read More

Natural history of abdominal wall soft tissue sarcoma is still poorly understood due to its rarity. In unpublished data of our institution, only seven cases of abdominal wall soft sarcoma with ICD-10 coding of 49.4 were found for past 10 years. Read More

A 3D model of abdominal aortic aneurysm (AAA) can provide useful anatomical information for clinical management and simulation. Thin-slice contiguous computed tomographic (CT) angiography is the best source of medical images for construction of 3D models, which requires segmentation of AAA in the images. Existing methods for segmentation of AAA rely on either manual process or 2D segmentation in each 2D CT slide. Read More

Background: With the increased popularity of bariatric surgery, the demand for body-contouring procedures is growing. Associated with these procedures are a number of complications due to different risk factors and patients' characteristics. The aim of this study was to assess the outcome of body-contouring procedures and correlate it to possible risk factors. Read More

Background: Minimally invasive esophagectomy is considered a beneficial approach to esophageal cancer, although a hiatal hernia occurs more frequently in this approach than in open esophagectomy with reconstruction via the mediastinal route. Development of an internal hernia to the retrosternal space is not a recognized complication of reconstruction via the retrosternal route after esophagectomy. We herein report three cases of the development of an internal hernia to the retrosternal space after minimally invasive esophagectomy. Read More

Authors:

This case report describes the use of a three-dimensional reconstruction technique to plan the abdominal incision in order to avoid incision-related complications in a 53-year-old female patient who had had a cystic mass in the liver for 16 years and had undergone four previous surgeries. The patient presented with a recurrent cyst. The surgical team used three-dimensional reconstruction to model the liver mass, the area of abdominal wall weakness due to previous surgeries, bowel adhesions, skeletal structure and whole abdominal contour. Read More

Authors:

Department of Surgery, University of Calgary and the Foothills Medical Centre, Calgary, Alberta, Canada.

Introduction: Abdominal wall hernias are a common source of morbidity and mortality. The use of biological mesh has become an important adjunct in successful abdominal wall reconstruction. There are a variety of biological mesh products available; however, there is limited evidence supporting the use of one type over another. Read More

Authors:

Zheng-Ying Jiang, MD, is a Burn Surgeon and Wound Repair Consultant; Ming-Zhuo Liu, PhD, MD; Zhong-Hua Fu, MD; Xin-Cheng Liao, MD, is Burn Surgeon and Wound Repair Consultant and Assistant Professor, Medical College of Nanchang University; Guang-Hua Guo, PhD, MD, is the Director of the Wound Repair Center and Chief Physician, Department of Burns, and a Professor, Medical College of Nanchang University, and the Chairman of Wound Repair Association, and Vice Chairman of the Chinese Burn Association; all at the Center of Wound Repair, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

With aging populations and the increased incidence of cerebrovascular disease, diabetes, and other diseases, more and more patients suffer from pressure injuries. Pressure injuries are often difficult to heal because of the presence of sinus tracts, which make it difficult to clean and change dressings. Sinus wounds are common in patients with pressure injuries, but also occur after abdominal wall incision and in patients who have experienced a physical trauma that created a wound. Read More

Background: The aim of this article is to report a case of filter-associated inferior vena cava (IVC) thrombosis with perforation of the duodenum and penetration of a vertebral body by the filter struts.

Case Report: A 37-year-old woman with a medical history of Behcet's disease treated with corticosteroids underwent placement of a retrievable IVC filter because of recurrent iliofemoral venous thrombosis regardless of therapeutic levels of anticoagulation. Despite a correct positioning of the filter, the second follow-up computed tomography scan, performed at 1 year, showed a complete thrombosis of the infrarenal IVC segment, with perforation of the vessel wall by the filter struts and penetration in the duodenum. Read More

Authors:

1 Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland.

Background And Aims:: The most effective dissection technique for raising the flap in abdominoplasty is still controversial, particularly in high-risk massive-weight-loss patients. LigaSure Impact vessel-sealing system (Medtronic, Dublin, Ireland) is an energy device commonly used among different surgical specialties to reduce morbidity and implement outcomes. The aim of this study was to investigate the effectiveness of LigaSure Impact in abdominoplasty compared with the conventional techniques, diathermia. Read More

Authors:

The association of thoracic epidural analgesia and urinary retention after complex abdominal wall reconstruction (CAWR) is unknown. The purpose of this study was to investigate the association between the presence of a thoracic epidural, timing of Foley catheter removal, and the rates of urinary retention and catheter-associated urinary tract infections (CAUTIs) in patients undergoing CAWR. All patients undergoing CAWR, who had an epidural catheter for postoperative pain management at our institution from September 2015 through April 2016, were prospectively followed. Read More

Methods: Full-thickness abdominal tissue (skin and subcutaneous fat) were donated from patients who underwent autologous breast reconstruction and gave consent to use their tissue for comprehensive research and medical educational purposes. Read More

Ventral or incisional hernia are a common disease pattern in general surgery. Mostcommonly, a mesh repair is used for reconstruction, whereby the mesh itself might causecomplications, like infections or adhesions. Biological materials, like biocellulose, might reducethese clinical problems substantially. Read More

Authors:

Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

A 57-year-old woman with morbid obesity (body mass index [BMI] of 43), systemic lupus on steroids, type 2 insulin-dependent diabetes, peripheral vascular disease, unprovoked pulmonary embolism on rivaroxaban, and hypertension presented with 3 days of worsening abdominal pain and nausea. She had an extensive surgical history including a cesarean section, multiple laparotomies for small bowel obstructions (one complicated by bowel perforation requiring resection), and a double-barrelled ileostomy, which had been since reversed. As a result, she had a massive incisional hernia (figure 1). Read More

Authors:

Department of Otolaryngology - Head and Neck Surgery, NYU Langone Medical Center, New York, United States.

AlloDerm is an acellular dermal matrix often used for reconstruction throughout the body. AlloDerm has been shown to undergo revascularization when used to reconstruct soft tissue such as in abdominal wall reconstruction. In this study, the authors review the literature on revascularization of AlloDerm and demonstrate the histologic findings of AlloDerm after implantation during skull base reconstruction. Read More

Authors:

Postsurgical pain management is critical to patient satisfaction and value. Several studies have evaluated liposomal bupivacaine (LB) in postoperative pain management protocols, however its economic feasibility remains undefined. This study analyzes the economic impact of LB using a national claims database to assess postoperative clinical and financial outcomes in plastic and reconstructive procedures. Read More

Background: Hispanics are the second largest demographic that underwent cosmetic surgery in 2017. The popularity of cosmetic surgeries among this group has increased significantly within the past decade and is projected to continue rising. Patient-directed websites that provide educational materials addressing these procedures should include information that is accurate, comprehensible, and sensitive to the demographic's diverse cultural and ethnic needs. Read More

Authors:

Background: During the course of performing abdominoplasties, a plastic surgeon will encounter a certain body habitus characterized by a thick, tethered, and excessively redundant upper skin flap. Often these patients also demonstrate diffuse and substantial fascial laxity. One approach to this problem involves direct thinning and release of the flap by resection of the sub-Scarpa's fat pad. Read More

Authors:

Background: Obesity is a major health risk factor associated with medical complications, such as cardiovascular disease, that may compromise outcomes. Furthermore, obesity may lead to difficulties in daily life, altering the quality of life and generating psychological disorders such as devalued self-image and depression.

Objectives: This study evaluated the quality of life and predictive factors of postoperative complications in patients who underwent abdominoplasty after Roux-en-Y gastric bypass. Read More

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